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Organization
FORT WORTH SENIOR CARE, LLC
Active
Organization
FORT WORTH SENIOR CARE, LLC
Active
Other names
Lakewood Village Personal Care Unit
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA MATHENY (AUTHORIZED SIGNATORY)
(423) 883-7920
Entity
Organization
Contact information
Practice address
5100 RANDOL MILL RD, FORT WORTH, TX 76112-1553
(817) 548-3200
Mailing address
5100 RANDOL MILL RD, FORT WORTH, TX 76112-1553
(817) 548-3200
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
09/13/2024
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